Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
Rates data updated October 2026.
How much does Calorically Dense Pediatric Enteral Formula cost?
$0.42
Typical negotiated rate. In Washington, October 2026.
Insurers have agreed to pay about $0.42 for this service. The price depends on where it is billed: about $0.42 from a physician practice, and about $1.51 from a hospital or other facility.
These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.
Prices by location type
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$0.42
$0.34 to $0.42
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$1.51
$0.79 to $2.00
How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $0 · 10th to 90th $0 to $0
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.34
Median
$0.34
Typical High
$0.34
Facility
None
$0.34
$0.34
$0.34
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.34
Median
$0.34
Typical High
$0.34
Professional
None
$0.34
$0.34
$0.34
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.05
Median
$0.05
Typical High
$0.05
Professional
55 · Aftercare only
$0.05
$0.05
$0.05
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.03
Median
$0.03
Typical High
$0.03
Professional
56 · Pre-op care only
$0.03
$0.03
$0.03
Asuris Northwest Health
Setting
Facility
Modifier
None
Typical Low
$0.93
Median
$0.93
Typical High
$0.93
Facility
None
$0.93
$0.93
$0.93
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.42
Median
$0.42
Typical High
$0.42
Professional
None
$0.42
$0.42
$0.42
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$0.79
Median
$0.79
Typical High
$0.79
Facility
None
$0.79
$0.79
$0.79
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$1.48
Median
$1.95
Typical High
$2.69
Facility
None
$1.48
$1.95
$2.69
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$1.17
Median
$1.17
Typical High
$1.32
Professional
None
$1.17
$1.17
$1.32
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Ambetter
Setting
Professional
Modifier
BO · Nutrition taken by mouth
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Professional
BO · Nutrition taken by mouth
$64.57
$64.57
$64.57
Where Washington sits
The same service costs 239.9 times more in Montana than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.